SurgeryNCT07653594
TRANScriptional Pathways Of Surgical Pain Modulated by Music Therapy Exposure (TRANSPOSE)
A study testing Music-assisted relaxation and imagery (MARI) in people with Surgery and Stomach Cancer, run by Case Comprehensive Cancer Center at 1 site in United States.
Trial summary
Participants may take part in this study if they are scheduled to undergo a surgery that meets the following: (1) traditional open surgery via laparotomy, (2) length of surgery >3 hours, and (3) curative-intent surgical resection of a cancer in the stomach, pancreas, bile ducts, liver, or peritoneal surfaces. Read more about this study
- Who is it for?
- Ages 50 to 80 years
- Conditions the study is for
- Surgery, Stomach Cancer, Pancreas Cancer
- What is being tested?
- Music-assisted relaxation and imagery (MARI)
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20 participants
- Where
- 1 siteUnited States
- Study dates
- Jan 2027to Dec 2027
- Phase
- Interventional
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 50 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 50 to 80
- Able to speak and understand English
- Scheduled to undergo a surgery meeting the following criteria: (1) traditional open surgery (not laparoscopic or robotic) via laparotomy (midline or subcostal incisions), (2) length of surgery >3 hours, and (3) curative-intent surgical resection of a cancer in the stomach, pancreas, bile ducts, liver, or peritoneal surfaces
- Participant reports pain intensity of 4/10 or above to study staff on day 1 post-surgery or any other day post-surgery through discharge
Who cannot join
- Significant visual impairment that has not been corrected
- Significant hearing impairment that has not been corrected
- Significant cognitive impairment that would prevent participant from participating in the study
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
United States1 site
University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center
Cleveland, Ohio, 44106
Samuel N Rodgers-Melnick, PhD, MPH, 216-844-7727, Samuel.RodgersMelnick@UHhospitals.org
Samuel N Rodgers-Melnick, PhD, MPH
About this study
Official title: TRANScriptional Pathways Of Surgical Pain Modulated by Music Therapy Exposure (TRANSPOSE): A Single Arm Pilot Study
Participants may take part in this study if they are scheduled to undergo a surgery that meets the following: (1) traditional open surgery via laparotomy, (2) length of surgery >3 hours, and (3) curative-intent surgical resection of a cancer in the stomach, pancreas, bile ducts, liver, or peritoneal surfaces. The purpose of this study is (1) to evaluate the feasibility of collecting blood samples prior to surgery, post-surgery and pre- music-assisted relaxation and imagery (MARI) intervention, and immediately post-MARI intervention and (2) to identify gene expression changes associated with MARI and explore their relationship with immediate changes in pain intensity. Participants will be in this study for the duration of their hospital admission for surgery.
Read the detailed description
People undergoing surgery for abdominal cancer often experience high levels of pain, stress, and anxiety. Managing these symptoms after surgery is difficult. People often require strong medications for pain relief and may have other comorbidities and anxiety that accompany surgery. Non-pharmacologic approaches, like music therapy (MT) are needed.
Music-assisted relaxation and imagery (MARI) combines live music with guided relaxation, breathing, and imagery. MARI can be personalized to people's preferences. MARI can also be recorded live so that a recording can be given to the participant to use afterward. In a prior study conducted by researchers, people who receiving palliative care reported a decrease in pain after experiencing MARI. In an additional study, MARI was found to more likely result in bigger decreases in pain when compared to traditional MT alone.
Even though there are several studies that support the efficacy of music interventions, like MARI and MT, for addressing pain after surgery, the biological mechanisms are not well understood. Recent advances in functional genomic science provide an opportunity to understand transcriptomic mechanisms. These approaches have been applied to mind-body therapies, recreational music making (RMM), and music listening. However, they have not yet been applied to MT.
A previous study showed that RMM led to a decrease in stress-induced immune response-related genetic markers in a group of healthy volunteers when compared to a control group. In a similar study, adults with cardiovascular disease also showed changes in their genetic markers when exposed to RMM.
However, to date no research has investigated the relationship between gene expression and pain in a medical population experiencing acute post-surgical pain. Given that people undergoing abdominal cancer surgery often experience severe pain, this population is well-suited for investigating the mechanisms by which MT influences acute pain.
- Conditions
- Surgery, Stomach Cancer, Pancreas Cancer, Bile Duct Cancer, Liver Cancer, Peritoneal Cancer
- Being tested
- Music-assisted relaxation and imagery (MARI)
- Keywords
- Music therapy, Music-assisted relaxation and imagery
- Medical subject headings
- Stomach Neoplasms, Pancreatic Neoplasms, Bile Duct Neoplasms, Liver Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Music-assisted relaxation and imagery (MARI)Behavioural
Also called MARI
Participants will provide their music and imagery preferences, which will be incorporated into the intervention. The intervention will consist of live guitar accompaniment personalized to participants' music preferences and a standardized script directing participants to release tension, take deep breaths, and explore a relaxing place. The MARI intervention will last about 30 minutes. The MARI intervention will be conducted on Day 1 (post-surgery) and a second timepoint determined by participant preference before the participant's hospital discharge (up to Day 30).
| Study group | Role | What they receive |
|---|---|---|
| Music-assisted relaxation and imagery (MARI) | Experimental | Participants will complete questionnaires to assess pain scores, participate in the MARI intervention, and undergo phlebotomy. Phlebotomy will occur prior to surgery (Day 0) as part of routine labs, post-surgery and pre- and post-MARI intervention (Day 1), and pre- and post-MARI intervention at a second timepoint determined by participant preference (up to Day 30). Receives: Behavioral: Music-assisted relaxation and imagery (MARI) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Proportion of participants whose phlebotomy was collected prior to surgery
The feasibility of collecting blood samples prior to surgery is measured by the proportion of participants whose phlebotomy was successfully collected.
Measured: Within 2 weeks prior to surgery
Proportion of participants whose phlebotomy was collected post-surgery (pre-MARI)
The feasibility of collecting blood samples post-surgery (and pre-MARI intervention) is measured by the proportion of participants whose phlebotomy was successfully collected.
Measured: Post-surgery and prior to MARI intervention (up to 30 days)
Proportion of participants whose phlebotomy was collected post-MARI
The feasibility of collecting blood samples post-MARI is measured by the proportion of participants whose phlebotomy was successfully collected.
Measured: Post-MARI intervention (up to 30 days)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Jun 2026
- Study startJan 2027 (estimated)
- Primary completionDec 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (13)Papers the sponsor has linked to this study.
- Other trials for SurgeryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 20 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Case Comprehensive Cancer Center
- Sponsor type
- University, hospital or other
- Collaborators
- National Center for Complementary and Integrative Health (NCCIH)
- Responsible party
- Sponsor
- Investigators
- Samuel N Rodgers-Melnick, PhD, MPH, Principal investigator, Case Comprehensive Cancer Center, University Hospitals
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07653594
- Sponsor's protocol ID
- CASE9226
- Status last verified
- Aug 2026
- First submitted
- 11 Jun 2026
- Last updated
- 5 Aug 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Bhasin MK, Dusek JA, Chang BH, Joseph MG, Denninger JW, Fricchione GL, Benson H, Libermann TA. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. PLoS One. 2013 May 1;8(5):e62817. doi: 10.1371/journal.pone.0062817. Print 2013.
PubMed 23650531Bhasin MK, Denninger JW, Huffman JC, Joseph MG, Niles H, Chad-Friedman E, Goldman R, Buczynski-Kelley B, Mahoney BA, Fricchione GL, Dusek JA, Benson H, Zusman RM, Libermann TA. Specific Transcriptome Changes Associated with Blood Pressure Reduction in Hypertensive Patients After Relaxation Response Training. J Altern Complement Med. 2018 May;24(5):486-504. doi: 10.1089/acm.2017.0053. Epub 2018 Apr 4.
PubMed 29616846Dusek JA, Otu HH, Wohlhueter AL, Bhasin M, Zerbini LF, Joseph MG, Benson H, Libermann TA. Genomic counter-stress changes induced by the relaxation response. PLoS One. 2008 Jul 2;3(7):e2576. doi: 10.1371/journal.pone.0002576.
PubMed 18596974Bittman B, Berk L, Shannon M, Sharaf M, Westengard J, Guegler KJ, Ruff DW. Recreational music-making modulates the human stress response: a preliminary individualized gene expression strategy. Med Sci Monit. 2005 Feb;11(2):BR31-40.
PubMed 15668624Bittman B, Croft DT Jr, Brinker J, van Laar R, Vernalis MN, Ellsworth DL. Recreational Music-Making alters gene expression pathways in patients with coronary heart disease. Med Sci Monit. 2013 Feb 25;19:139-47. doi: 10.12659/MSM.883807.
PubMed 23435350Kanduri C, Kuusi T, Ahvenainen M, Philips AK, Lahdesmaki H, Jarvela I. The effect of music performance on the transcriptome of professional musicians. Sci Rep. 2015 Mar 25;5:9506. doi: 10.1038/srep09506.
PubMed 25806429Kanduri C, Raijas P, Ahvenainen M, Philips AK, Ukkola-Vuoti L, Lahdesmaki H, Jarvela I. The effect of listening to music on human transcriptome. PeerJ. 2015 Mar 12;3:e830. doi: 10.7717/peerj.830. eCollection 2015.
PubMed 25789207Liu Q, Li L, Wei J, Xie Y. Correlation and influencing factors of preoperative anxiety, postoperative pain, and delirium in elderly patients undergoing gastrointestinal cancer surgery. BMC Anesthesiol. 2023 Mar 13;23(1):78. doi: 10.1186/s12871-023-02036-w.
PubMed 36915054Ozhanli Y, Akyuz N. The Effect of Progressive Relaxation Exercise on Physiological Parameters, Pain and Anxiety Levels of Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Study. J Perianesth Nurs. 2022 Apr;37(2):238-246. doi: 10.1016/j.jopan.2021.08.008. Epub 2021 Dec 10.
PubMed 34903440Risser K, Block S, Surdam J, Yu H, Doh SJ, Bretz S, Hoehn RS, Rodgers-Melnick SN. Music Therapy in Patients Undergoing Pancreatic Surgery (MUSIC PUPS): A Mixed Methods Pilot Study. Glob Adv Integr Med Health. 2025 Aug 13;14:27536130251368796. doi: 10.1177/27536130251368796. eCollection 2025 Jan-Dec.
PubMed 40822036Rodgers-Melnick SN, Lin L, Gam K, Souza de Santana Carvalho E, Jenerette C, Rowland DY, Little JA, Dusek JA, Bakshi N, Krishnamurti L. Effects of Music Therapy on Quality of Life in Adults with Sickle Cell Disease (MUSIQOLS): A Mixed Methods Feasibility Study. J Pain Res. 2022 Jan 11;15:71-91. doi: 10.2147/JPR.S337390. eCollection 2022.
PubMed 35046718Gutgsell KJ, Schluchter M, Margevicius S, DeGolia PA, McLaughlin B, Harris M, Mecklenburg J, Wiencek C. Music therapy reduces pain in palliative care patients: a randomized controlled trial. J Pain Symptom Manage. 2013 May;45(5):822-31. doi: 10.1016/j.jpainsymman.2012.05.008. Epub 2012 Sep 24.
PubMed 23017609Rodgers-Melnick SN, Gunzler D, Love TE, Koroukian SM, Beno M, Dusek JA, Rose J. Impact of sociodemographic, clinical, and intervention characteristics on pain intensity within a single music therapy session. J Pain. 2025 Nov;36:105556. doi: 10.1016/j.jpain.2025.105556. Epub 2025 Sep 11.
PubMed 40945641